Trial of Docetaxel, Oxaliplatin and Capecitabine (TEX) in Advanced or Metastatic Gastric Cancer

Inclusion Criteria: * Written informed consent * Histologically proven irresectable, metastatic or recurrent adenocarcinoma of the stomach or the gastroesophageal junction, i.e., Tx-4 M1 or T4 M0 * Irresectable (as judged by an experienced surgeon): 1. T4 infiltrating of several organs 2. T4 infiltrating one organ, but irresectable 3. T4 infiltrating one organ, respectable, but inoperable patient * The nodal status is neglected * Measurable disease according to RECIST * ECOG Performance Status ≤ 2 * Male or female patients aged ≥ 18 years * Life expectancy ≥ 3 months * Adequate bone marrow, hepatic and renal function: 1. Haemoglobin \> 9.0 g/dL (transfusions allowed to achieve or maintain levels) 2. Absolute neutrophil count \> 1.5 x 10\^9/L 3. Platelet count \> 100 x 10\^9/L 4. ALAT, ASAT \< 3.5 x ULN 5. Alkaline phosphatase \< 6 x ULN 6. Total bilirubin \< 1.0 x ULN 7. Creatinine clearance \> 50 mL/min (calculated according to Cockroft and Gault) * Prior surgery must be more than 28 days ago * Positive nodes as diagnosed on endorectal ultrasound and/or MRI (tumour is staged by preferably a high resolution MRI; if MRI is not available, locoregional staging must be performed by computed tomography plus endorectal ultrasound) * Tumor staging must be done within 28 days from the start of the treatment * Negative pregnancy test in women with childbearing of potential (within 7 days prior to the start of the chemotherapy) * Postmenopausal women must have been amenorrheic for at least 12 months to be considered of non-childbearing potential Exclusion Criteria: * Prior cytotoxic chemotherapy or radiotherapy (a neoadjuvant or adjuvant chemotherapy must be completed and without progression for at least 6 months) * Previous (within the last 5 years) or concurrent malignancies, with the exception of adequately treated in situ carcinoma of the cervix or basal cell carcinoma of the skin * Peripheral neuropathy ≥ grade 2 (according to NCI CTCAE v 3.0) * Patient must not have been treated with any investigational drug, agent nor procedure, (i.e., did not participate in another trial within 30 days) before entry in this trial * Known allergy or any other adverse reaction to any of the study drugs or to any related compound * Requirement for concurrent use of the antiviral agent sorivudine (antiviral) or chemically related analogues, such as brivudine * Clinically significant concomitant diseases, such as: 1. Active infection necessitating systemic antibiotics 2. Interstitial lung diseases 3. Chronic diarrhea, inflammatory bowel disease 4. Neurological or psychiatric disease, dementia, epilepsy or untreated brain metastases * Cardiac disease (e.g., congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmia not well controlled with medication) or myocardial infarction or resuscitation within the last 6 months * Pregnant or lactating women are excluded * Presence of adequate contraception in fertile patients (methods of adequate contraception are: intra-uterine device, hormonal contraception, vasectomy, tubal ligation or abstinence) * Alcohol or drug abuse * Ability to swallow tablets * Psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule